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【Abstract】Objective To study the imaging manifestations of CT and MRI in diagnosis of adrenal tumors. Methods CT manifestations in 27 cases with confirmed adrenal tumors by surgery and pathology were analyzed retrospectively, there were 10 cases accepting MR examination. Results Cortical tumors were seen in 9 cases, including adenomatous hyperplasia in 3 cases, adenoma in 4, cortical adenocarcinoma in 2；Medullary tumors were seen in 9 cases, including pheochromocytoma in 5 cases, metastasis in 3, neuroblastoma in 1；interstitial tumors were seen in 9 cases, including myelolipoma in 4 cases, and neurofibroma，cyst, lymphoma, malignant transformation of mesothelioma, malignant mesenchymal tumor in one, respectively. Conclusion Although adrenal tumors was certain characteristics of imaging features, we should combine clinic findings when making a diagnosis. Diagnosis of some solid interstitial tumors is difficult merely relying upon imaging and histopathological examination is needed .
【Key words】 Adrenal tumor Tomography X-ray computed MRI
肾上腺肿瘤组织来源较复杂，分为主质细胞（实质和髓质）肿瘤和间质细胞肿瘤［１，２］，间质肿瘤少见，有的肿瘤罕见，一般仅见个案报告。作者搜集2000年10月至2006年4月27例肾上腺肿瘤，其中少见和罕见肿瘤9例，分析CT、MRI影像学表现特征，以提高对肾上腺肿瘤的认识。
1 资料与方法
1.1 一般资料
本组27例肾上腺肿瘤中，男14例，女13例；年龄2.5～81岁，平均45.6岁。临床表现：腺瘤和腺瘤样增生7例，表现为Cushing's综合征2例，Conn's综合征1例，4例无临床症状；2例皮质腺癌中均有Cushing's综合征；5例嗜铬细胞瘤表现为高血压，其中阵发性高血压3例，持续性高血压1例，高低血压交替1例，并有头痛、心悸等症状；1例转移瘤、1例骨髓脂肪瘤、间皮瘤恶变、间叶组织来源恶性肿瘤表现为上腹部不适；其余患者无明显临床症状，为体检及腹部影像学检查所发现。
1.2 研究方法
患者均行CT 平扫加增强，检查前30min常规口服2％泛影葡胺500～1000ml。使用SIEMENS SOMATOM Plus 4 Power螺旋CT扫描仪，Slice 2～5mm，Feed/Rot 3～7.5 mm，Pich 1.2～1.5。增强扫描经肘静脉高压注射300mgⅠ/ml欧苏100ml，速率2.5～3ml/s，约25～70s后扫描动、静脉期，范围包括肾上腺及肾脏。10例患者作了MRI检查，MR机为SIEMENS MAGNETOM Harmony 1.0T型，层厚3～5mm，层间距1mm。扫描序列为常规横断位、冠状位SE T1WI、TSE T2WI，全部患者加扫脂肪抑制序列，部分加扫化学位移成像，1例嗜铬细胞瘤作了腹主动脉、肾动脉CE-MRA。
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